Provider Demographics
NPI:1386931988
Name:DEAN, JONATHAN P (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:P
Last Name:DEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 DOCTORS DR STE 320
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-4565
Mailing Address - Country:US
Mailing Address - Phone:828-586-3976
Mailing Address - Fax:
Practice Address - Street 1:98 DOCTORS DR STE 320
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-4565
Practice Address - Country:US
Practice Address - Phone:828-586-3976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117795208600000X
NC2022-01859208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery